Newsletter

Mammogram Screening

Mammography screening remains the best available method to detect breast cancer early. However, no medical test is always 100 percent accurate, and mammography is no exception. Research is under way to improve the technology to lead to better accuracy and to create new technologies.

In 1992, the U.S. Congress passed the Mammography Quality Standards Act to ensure that mammography facilities throughout the country are of high quality and are reliable. To lawfully perform mammography, each facility must prominently display a certificate issued by the U.S. Food and Drug Administration (FDA). This certificate serves as evidence that the facility meets quality standards.

It is important for women to practice the elements of good breast health. It is suggested women:

Q: What is an MRI and isn't this test more effective than mammography?A: Magnetic resonance imaging tests, or MRIs, are more thorough than mammograms and can better spot some cancers, but they also detect more growths that look suspicious but are actually benign. They're also much more expensive and may not be covered by insurance. In addition, MRI-guided biopsies are not widely available. In short, case-by-case decisions make the most sense.

Q: What should women expect when they have a mammogram?A: A woman who still menstruates should schedule the mammogram for one week after her menstrual period begins, when the breasts will be the least tender. Women are asked to avoid using deodorant and lotions on the day of the mammogram and should wear two-piece clothing to make undressing more convenient. A specially trained radiologic technologist will perform the mammogram. The woman will be asked to undress from the waist up only and stand next to the x-ray machine. Two flat surfaces will compress one breast first, then the other for a few seconds. Compression is necessary to produce the best pictures using the lowest amount of radiation possible.

Q: What barriers keep women from getting mammograms on a routine basis?A: Studies have identified a number of barriers to mammography screening. Some can be overcome with health education; others require programs to make mammography more accessible for women. The top barriers, in women's words, are:

"I don't need a mammogram because my doctor has never recommended I have one."

"I've never thought about it."

"I have no breast problems, so mammography isn't necessary."

"I don't have enough time."

"I have had a mastectomy (double mastectomy, radical mastectomy) and don't have breasts."

"I don't have a family history of breast cancer"

Other barriers include:

Fear about pain from the procedure.

Fear of a diagnosis of breast cancer.

Concerns about screening costs.

Concerns about the financial burden of diagnostic procedures and treatment, if needed.

No recent clinical breast examination or Pap test.

No routine source of health care.

Difficulty taking time off from work to be screened.

Living a far distance from the screening site.

Source: The Manual of Intervention Strategies to Increase Mammography Rates, Centers for Disease Control and Prevention with the Prudential Center for Health Care Research.

Q: Will health insurance pay for screening mammograms?A: Regular screening mammograms are covered by the U.S. government's Medicare and Medicaid programs and other private health insurance plans (women should check their own insurance plans for individual details). Free or low-cost mammograms are available for women without health insurance in many locations. For a program near you, contact the CDC at (888) 842-6355.

Q: Will Medicare pay for screening mammograms?A: Yes. Medicare covers mammography screening every year. Yet, eligible women and their doctors may not know about this important benefit. A series of publications regarding this benefit are available in English and Spanish. For more information about Medicare coverage, contact the Medicare toll-free hotline at (800) MEDICARE or the Medicare Web site.

Q: How can women get low-cost or free mammograms?A: For information on low- or no cost mammography screening, contact the Centers for Disease Control and Prevention (CDC) at (888) 842-6355 or visit their Web site. Women seeking mammograms at a reduced rate are urged to make their appointment early in the year, as space may be limited. To find a breast-imaging facility, contact the National Cancer Institute at (800) 4-CANCER.